What is tooth whitening?
Tooth whitening refers to procedures that are meant to whiten the enamel of teeth. Enamel is the outer layer of the teeth that we see when we smile. Tooth whitening procedures can be divided into three approaches: professional whitening, over-the-counter whitening, or “alternative” or DIY whitening. Professional whitening refers to whitening procedures that are performed under the care of a dentist and may be done in-office or at-home. There are many misconceptions about tooth whitening procedures, so read on to learn more!
What are the benefits of tooth whitening?
Tooth whitening is a quick and relatively inexpensive way to improve the appearance not just of the teeth themselves, but of the patient’s overall smile and facial esthetics. Research has shown that a whiter smile is linked to higher confidence and self-perception. Professional tooth whitening is a safe and effective way to achieve that whiter smile.
Is professional tooth whitening safe?
Yes! When used as directed, professional tooth whitening procedures are completely safe and will not damage teeth.
Read below for discussion about “alternative” or DIY whitening techniques you might see on social media or the internet. There may be risks with these whitening methods.
What are my options for bleaching?
We offer our patients here at 44 West Dental Professionals two great options for professional tooth whitening:
- Custom at-home bleaching trays
After taking impressions of the patient’s teeth, we fabricate custom-made clear trays for the patient to use at home. An optimal outcome is usually achieved within 2 weeks when using the trays daily as directed. We demonstrate the proper way to use the tray with the special whitening gel. Because the trays are custom-made, the whitening gel evenly disperses over the teeth and in between teeth for an even whitening outcome. This is also less messy than OTC whitening strips, as the custom trays are able to restrict the flow of the gel so it stays on the teeth and does not flow onto the gums where irritation could otherwise result. We offer two options for whitening trays depending on how a patient prefers to bleach:
- Philips DayWhite™: A 14% hydrogen peroxide whitening agent that is worn during the day for either a single 30-minute application or two 15-minute applications. Hydrogen peroxide as a whitening agent works faster than other alternatives, allowing it to be worn for less time per application. This is the most common application for custom trays and works exceptionally well for most patients.
- Philips NiteWhite™: A 16% carbamide peroxide whitening agent that is worn overnight. Carbamide peroxide as a whitening agent works slower than hydrogen peroxide, allowing it to be worn for more extended periods of time. Certain shades of discoloration have been shown to respond better to these longer applications with carbamide peroxide.
- ZOOM!™ Professional in-office bleaching
This whitening option allows a patient to see an improvement of up to 8 shades whiter in just one 45 minute office appointment. For this procedure, the Zoom!™ whitening gel is applied directly to the patient’s teeth using by our professional clinical staff. They use a special technique to block out the gums so that only the teeth receive the gel, then the gel is activated by the Philips WhiteSpeed™ blue LED light. These techniques allow for us to use stronger concentrations of whitening agent that what can be used in trays at home. The gel and process is completely safe and dramatic results are seen in just one visit. Even though this treatment option is done in a single visit, at 44 West we will still fabricate custom trays for the patient to use for potential future touch-up procedures. See below for more information on touch-ups.
Over-the-counter whitening products are also available. This category of whiteners includes a variety of different application methods, including whitening strips, stock (non-custom) trays, toothpastes, and rinses. Whitening toothpastes and rinses whiten by removal of external stains only. White strips do bleach intrinsically like at-home trays or ZOOM!™, but with less effectiveness due to weaker ingredients and less controlled delivery methods. They also tend to be messier because they are not custom fit to the patient’s teeth, which can result in gum irritation. These products are available from a variety of retailers.
How does tooth whitening work?
To answer this question, it is beneficial to understand the difference between the two types of tooth stain/discoloration:
- Extrinsic discoloration – This type of discoloration is caused from foods, beverages, and habits like smoking, coffee and wine. These stains adhere to the outside of the teeth. This type of discoloration is removed during routine dental cleanings. Some whitening toothpastes may remove some of these stains as well as slow new stains from adhering to the teeth. These toothpastes work through the use of abrasive agents to remove the surface stains.
- Intrinsic discoloration – This type of discoloration is present within the teeth. Intrinsic discoloration has been shown to naturally progress as we age, though there are a number of factors that can accelerate this process such as smoking, certain medications, childhood illness, or trauma. Whitening toothpastes or rinses do not affect these types of stains because they are present deeper within the structure of the tooth. Generally when we talk about tooth whitening, intrinsic discoloration is what we are looking to remove.
The two active ingredients used for the whitening of intrinsic stains are hydrogren peroxide and carbamide peroxide, though they come in different formulations and concentrations depending on the method of delivery. These products work by penetrating the deeper layers of the tooth enamel. Upon contact with a specific microscopic bond between carbon atoms within the enamel that is the cause of intrinsic staining, oxygen molecules will form which break these bonds and result in whiter enamel structure. This process is completely safe and will not harm enamel.
What about “alternative” or DIY home bleaching options I see discussed on social media or the internet?
We generally recommend avoiding DIY tooth whitening solutions for a few reasons. First, we have seen formulations that contain acidic ingredients. These can remove intrinsic discoloration and whiten teeth, but at the cost of stripping or eroding enamel. Another approach which also may whiten teeth temporarily uses ingredients that are very abrasive. These sorts of techniques will remove extrinsic discoloration to whiten teeth temporarily, but also may cause irreversible damage to enamel with repeated use. Finally, there are other techniques which simply aren’t effective. A common thought is that since hydrogen peroxide is a tooth whitening agent to just swish with a liquid hydrogen peroxide solution. This will work in theory, but liquid solutions are generally 3% hydrogen peroxide. So in order to equal a 30 minute application with 14% whitening gel, you would have to swish with liquid peroxide for over two hours, which is neither practical nor safe, as this would likely damage the soft tissues of the mouth.
Professional tooth whitening is both safe and effective. And over time it is also relatively inexpensive. Once our whitening patients have their trays they will keep them for life, so the initial investment will last many years. If we later perform dental work such as crowns or fillings that affect the fit of a tray, we will make a new tray at no charge to the patient.
Is the whitening result permanent or can my teeth yellow or stain again?
Unfortunately, no whitening procedure is permanent. As we continue to eat, drink, and age they will again develop both intrinsic and extrinsic discoloration. Everyone is different with how quickly their teeth will start to yellow or stain. This is where the advantage of professional whitening solutions lies. Once you have your trays from your initial at-home or ZOOM!™ whitening, you can use these to touch-up periodically. How often you have to do this differs by the individual, but commonly patients will touch-up roughly every 6, 12, or 18 months. To touch-up, you will not need to do the full initial whitening procedure for 2 weeks. Rather a few applications are typically all that is required to return you to your desired shade.
Are there any reasons I shouldn’t whiten my teeth?
There are a few patients who shouldn’t undergo tooth whitening. As a precaution, we recommend pregnant women or nursing mothers postpone any whitening procedures. We also recommend a minimum age of 14 for take-home trays and 16 for ZOOM!™ whitening. We may also make individual recommendations depending on the patient’s unique circumstances.
Are there any side effects of tooth whitening?
Temporary tooth sensitivity is the most common side effect of whitening procedures. We have ways to decrease the level or longevity of sensitivity, such as through the use of desensitizing gels in the trays before or after whitening. Another way to reduce sensitivity is by decreasing the frequency of use of the at-home trays. Instead of daily use, they can be used every other day. This will reach the same level of whitening as daily use, though it does take longer. Using these and other desensitizing techniques, we have had great success controlling sensitivity even in patients with very sensitive teeth.
I am interested in whitening my teeth, is there anything else I should know?
It is important that the teeth and gums are in a healthy condition before attempting bleaching. Patients with active tooth decay or gum disease should have those issues addressed before tooth whitening procedures. There are also certain types of stain or tooth discoloration that cannot be improved by whitening alone. Give us a call at (616) 530-2200 to schedule a consultation to discuss the best way to improve your smile.